We live in a pharma-rich country with a health care system that encourages everyone to dig in. I do not. Instead, I encourage all my patients to take a close look at the pill-for-what-ails-you approach that your doc, the pharmaceutical companies and health insurers perpetuate. Are drugs always the answer? And what’s in it for your health? Here’s another question worth asking: Given that so many common ills don’t actually warrant drugs, why is just about everyone on them? Here are a few thoughts to consider the next time your doc whips out the prescription pad:

Health care is a business.

In this country, health care delivery isn’t really built on creating health. It’s focused more on generating profits – Big Pharma keeping the drug conveyor belt moving and its bottom line healthy. With medical conglomerates and insurance companies taking their cut as well, physicians are left scrambling to manage huge caseloads, moving patients through the system at the speed of an Indy 500 pit crew. Again, great for profits, but not for cultivating health. At the pace they’re expected to maintain (and, often, financially rewarded for), few, if any, mainstream physicians have the time or the incentive to get to the bottom of your condition or come up with healthier, integrative ways to improve it.

The default is assembly-line, quick-fix, put-a-band-aid-on-it medicine – stabilize the patient with pharmaceuticals, and onto the next appointment. Another factor driving the prescription tsunami is fear – physicians afraid to bypass pharmaceuticals just in case there is some chance they may help.  Because U.S. patients are so conditioned to expect medications, their doctors risk reproach at best and malpractice suits at worst if the drugs aren’t prescribed. So those prescription pads are always at the ready. And the more people ‘treated’ equals means more profit for the practice (these days, usually part of a corporate or university mega-entity) and the drug companies. Everybody wins, except, quite possibly, you, not when those side-effects start to kick in.

Conventional medicine isn’t bad per se – it’s just got issues.

Now, don’t get me wrong. Sometimes prescription drugs are lifesavers, and I’m all for the right medication for the right patient for the right problem, especially in acute situations.  If you have a severe infection, you can give thanks for the antibiotics that beat it down.  If you have high blood pressure—systolic numbers consistently above 160 are a serious danger sign —medication may well prevent a stroke.  If you’re severely depressed, suicidal, or disabled by anxiety, the temporary use of an antidepressant or antianxiety medication might give you the breathing room you need to make some needed life changes. Likewise, if you’re suffering from severe pain or even just intense discomfort, the temporary use of a pain reliever or other appropriate medication may bring some much-needed relief. So yes, the judicious use of pharmaceuticals can have a role to play. But it’s the over-prescription of drugs that I have a problem with, and you should too.

Beware the prescription pile-on.

So, what’s wrong with having a couple of prescriptions? Well, beside the cost, virtually all of Big Pharma’s heavy hitters come laden with side-effects, and they have a nasty habit of amplifying each other. I see it every day as patients arrive at my office in varying states of distress. They’re on multiple meds and feeling lousy. Their condition is being ‘treated’ by conventional medicine, but far from improved. Why? All the systems, symptoms, and medications in their bodies are constantly “speaking” to each other. The negative effects produced by one drug often lead to the prescription of a second drug which can lead to a third drug – the side effects just pile up. It’s the definition of a viscous cycle. Even if you’re only taking one medication, it can still disrupt your natural balance and make you feel like crap.

The truth is, many common prescription medications can create weight gain, brain fog, memory problems, fatigue, joint pain, sleep problems, gastrointestinal issues and other symptoms. That can easily lead to more prescriptions and/or misdiagnoses for otherwise reversible or more naturally manageable conditions. Take, for example, statins, which, among other problems, can create brain fog so severe, patients have been wrongly diagnosed with Alzheimer’s. When the statins are removed, under a doctor’s close supervision, the problem disappears. (Frightening but true!)

There are also dependency and addiction issues to consider, with pharmaceuticals like anti-depressants, opioids and sleep meds among the most frequent troublemakers. Another potential problem? Big Pharma’s fix-it-later or maybe even recall-it-later approach often leaves a trail of billion-dollar lawsuits in its wake (think Vioxx, Paxil, Wellbutrin, etc.). Again, you have to wonder, how much does your health matter in the ever-more profitable business of disease management? Granted, some medications are better than others but … buyer beware!

More medicine isn’t good medicine.

A great deal of the prescribe-it-away problem comes from the way we physicians are trained.  Medical school provides us with lots of information but, all too often, it does not teach us to look at the underlying causes of disease, nor to focus on such basic solutions as diet, supplements, exercise, stress relief, and sleep.  Instead, we’re taught to identify symptoms—and then to treat each symptom with its matching drug. Managing poor health winds up having little to do with putting patients on a path to long-term wellness. This too works in Big Pharma’s economic favor – the sick remain reliant on drugs to keep them in a sort of pharmaceutically-dependent Twilight Zone. Score one for Big Pharma – an endless supply of customers!

Good medicine is about creating wellness.

The sad reality is that many medications are often unnecessary. A great deal of research shows that, in many cases, diet, supplements, exercise, stress relief, and improved sleep work better than any medication ever could – which is why I encourage every patient to think of pharmaceuticals as a last resort rather than the first!

Crazy as it seems, some prescribed medications are routinely given to people who won’t derive any benefit from them. For example, statins are handed out like candy, yet they’ve been proven effective primarily for those who have already had a heart attack -- and even so, side-effect-free lifestyle changes are likely far more effective than statins. Likewise, blood pressure meds definitely have their place but you’ll likely get a much more profound risk reduction only if you lower the numbers through diet, exercise, and stress relief. At a minimum, lifestyle changes should mean being able to lower the drug dosage and that means less significant side-effects.

Again, I’m not saying medications can’t be necessary – they are sometimes lifesavers – and I get that not everyone is willing to put in the work to change their lifestyles enough to reverse their health problems. But the big idea here is about not completely relying on Big Pharma to keep you healthy. That’s your job, not theirs.

Dialing down your relationship with Big Pharma -- with care.

Do not—I repeat, DO NOT—change the dosage of any prescription medication you are taking, and NEVER stop taking any medication, without DISCUSSING IT WITH YOUR DOCTOR FIRST. Many prescription medications have a cumulative effect – they can fundamentally re-wire your system – so if you reduce or stop them cold turkey, you could be shocking your body in painful, dangerous or even life-threatening ways. No freestyling here! If you would like to change your relationship to prescription or even over-the-counter medications, you MUST work with your doctor – no exceptions.  

Good medicine is about creating wellness.

As a health evangelist for more than three decades, I’m a man on a mission, no doubt. It is, to show the unwell how they can transform their health, safely, ideally, with as few drugs as possible. With roughly 80% of chronic diseases being driven by lifestyle factors, addressing root causes and putting in the work to upgrade the way you eat, sleep, move and de-stress is a far better prescription than relying on meds to mask what’s really wrong. The time to start turning the health tide is now, and always remember, the power to do that is in your hands.